MIDWEST INTEGRATED MEDICAL CENTER LLC (NPI# 1770095796) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1770095796 |
| Entity Type | Organization |
| Organization Name | MIDWEST INTEGRATED MEDICAL CENTER LLC |
| Practice Address |
2920 Enloe St Ste 105 Hudson WI 54016-8191 |
| Practice Telephone | 7158080716 |
| Mailing Telephone | 7158080716 |
| Enumeration Date | 2017-10-31 |
| Last Update Date | 2018-01-22 |
| Authorized Official Name | DR. DARYL COOPER (OWNER) |
| Authorized Official Telephone | 7158080716 |
| Authorized Official Credential | DC |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QM1300X |
Clinic/Center Specialization: Multi-Specialty |
Ambulatory Health Care Facilities |
| Street Address |
2920 ENLOE ST STE 105 |
| City | HUDSON |
| State | WI |
| Zip Code | 54016-8191 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1548497605 | Daryl Lee Cooper | Chiropractor | 2920 Enloe St Ste 105, Hudson, WI 54016-8191 | 2009-06-16 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1164921128 | Sara Lynn Henry | Occupational Therapy Assistant | 1320 Wisconsin St., Husdon, WI 54016 | 2018-02-06 |
| 1689003436 | Serving Hands Inc | Home Health | 1419 Boulder Court, Hudson, WI 54016 | 2013-11-02 |
| 1275973042 | Lisa Renee Haverly | Occupational Therapist | 477 Perch Lake Rd, Hudson, WI 54016 | 2013-06-26 |
| 1710320213 | Emily Ann Stevenson | Counselor | 901 4th St Ste 165, Hudson, WI 54016 | 2013-04-15 |
| 1083972954 | The Shurden Group | In Home Supportive Care | 2424 Monetary Blvd. #012, The Shurden Group Dba Comfort Keepers, Hudson, WI 54016 | 2012-04-30 |
| 1124305933 | Robert Michael Catlow-price | Massage Therapist | 131 Carmichael Road, Suite #202, Hudson, WI 54016 | 2011-11-08 |
| 1962780221 | Qin Chu | Acupuncturist | 1615 Maxwell Dr., Suite D, Hudson, WI 54016 | 2011-08-03 |
| 1124324231 | Hung Trieu Lieu | Acupuncturist | 1810 Crest View Dr Ste 4a, Hudson, WI 54016 | 2011-02-07 |
| 1912214966 | Sumac Residential LLC | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | 723 B Blue Jay Lane, Hudson, WI 54016 | 2010-09-10 |
| 1740593201 | Michelle Marie Young | Counselor | 2501 Hanley Road, Suite F, Eagle Valley Bank Building, Hudson, WI 54016 | 2010-07-26 |
| Find all providers in zip 54016 | ||||
| Taxonomy Code | 261QM1300X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Multi-Specialty |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1497001358 | Columbia Memorial Hospital | Clinic/Center | 71 Prospect Ave Ste 190, Hudson, NY 12534 | 2012-07-30 |
| 1194386680 | Columbia Memorial Hospital | Clinic/Center | 71 Prospect Ave, Hudson, NY 12534-2907 | 2019-06-25 |
| 1003363466 | Columbia Memorial Hospital | Clinic/Center | 71 Prospect Ave, Hudson, NY 12534-2907 | 2016-09-02 |
| 1427420181 | Group Health Plan Inc | Clinic/Center | 411 Stageline Rd, #200, Hudson, WI 54016 | 2015-10-21 |
| 1851775894 | Columbia Memorial Hospital | Clinic/Center | 71 Prospect Ave, Suite 240, Hudson, NY 12534-2907 | 2015-07-18 |
| 1750790648 | Columbia Memorial Hospital | Clinic/Center | 71 Prospect Ave, Suite 240, Hudson, NY 12534-2907 | 2014-08-05 |
| 1568874287 | Columbia Memorial Hospital | Clinic/Center | 71 Prospect Ave, Suite 110, Hudson, NY 12534-2907 | 2014-05-29 |
| 1629497250 | Columbia Memorial Hospital | Clinic/Center | 71 Prospect Ave, Suite L30, Hudson, NY 12534-2907 | 2014-04-10 |
| 1417371519 | Columbia Memorial Hospital | Clinic/Center | 71 Prospect Ave, Suite 290, Hudson, NY 12534-2907 | 2014-02-10 |
| 1548606775 | Hudson Physicians S.c. | Clinic/Center | 403 Stageline Rd, Hudson, WI 54016-7848 | 2013-05-15 |
| Find all providers in HUDSON | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.